بررسی بیماری در مادران باردار و اثر آن روی حاملگی

با فرمت قابل ویرایش word - بررسی بیماری های مزمن در مادران باردار - بررسی بیماری در مادران بالای 35 سال و اثر آن روی حاملگی

فهرست مطالب

عنوان صفحه                     

چکیده........................................................................................................................................................................................................................................................................ 1

مقدمه.......................................................................................................................................................................................................................................................................... 3

فصل اول  : کلیات.................................................................................................................................................................................................................................................. 4

1-1-بیان مسئله..................................................................................................................................................................................................................................................... 5

1-2-فرضیه.............................................................................................................................................................................................................................................................. 5

1-3- اهداف اصلی................................................................................................................................................................................................................................................. 5

1-4-اهداف کاربردی............................................................................................................................................................................................................................................. 5

1-5-ضرورت های خاص...................................................................................................................................................................................................................................... 6

1-6-روش تجزیه وتحلیل اطلاعات.................................................................................................................................................................................................................. 6

فصل دوم : بررسی متون و مقالات..................................................................................................................................................................................................................... 7

2-1-اختلالات پرفشاری خون در حاملگی.................................................................................................................................................................................................... 8

2-1-1-تعریف و طبقه بندی ............................................................................................................................................................................................................................. 8

2-2-پره اکلامپسی................................................................................................................................................................................................................................................ 11

2-2-1-سبب شناسی.......................................................................................................................................................................................................................................... 13

2-2-2-پاتوفیزیولوژی.......................................................................................................................................................................................................................................... 14

2-2-3-پیش گیری............................................................................................................................................................................................................................................... 16

2-3-پره اکلامپسی خفیف.................................................................................................................................................................................................................................. 16

2-3-1-تشخیص پره اکلامپسی خفیف.......................................................................................................................................................................................................... 16

2-3-2-برنامه درمانی پره اکلامپسی خفیف.................................................................................................................................................................................................. 16

2-4-پره اکلامپسی شدید................................................................................................................................................................................................................................... 18

2-4-1-برنامه درمانی پره اکلامپسی شدید................................................................................................................................................................................................... 18

2-5-سندرم HELLP........................................................................................................................................................................................................................................... 20

2-5-1-تشخیص سندرم HELLP................................................................................................................................................................................................................... 20

2-5-2-برنامه درمانی سندرم HELLP........................................................................................................................................................................................................... 20

2-6-اکلامپسی....................................................................................................................................................................................................................................................... 20

2-6-1-برنامه درمانی اکلامپسی....................................................................................................................................................................................................................... 21

2-7-هایپرتانسیون مزمن.................................................................................................................................................................................................................................... 21

2-7-1-برنامه درمانی .......................................................................................................................................................................................................................................... 22

2-8-دیابت شیرین وحاملگی............................................................................................................................................................................................................................. 24

2-8-1-متابولیسم سوخت های بدن............................................................................................................................................................................................................... 24

2-8-2-طبقه بندی دیابت................................................................................................................................................................................................................................... 26

2-8-3-غربالگری و تشخیص دیابت حاملگی............................................................................................................................................................................................... 27

2-8-4-عوارض حاملگی...................................................................................................................................................................................................................................... 28

2-8-5-عوارض نوزادی........................................................................................................................................................................................................................................ 30

2-8-5-1-مرگ و میر حوالی تولد(پری ناتال)............................................................................................................................................................................................. 30

2-8-5-2-تغییر رشد جنین.............................................................................................................................................................................................................................. 31

2-8-5-3-ناهنجاری های متابولیک................................................................................................................................................................................................................. 32

2-8-5-4-سایر عوارض نوزادی........................................................................................................................................................................................................................ 33

2-8-6-برنامه درمانی دیابت............................................................................................................................................................................................................................... 34

2-8-6-1-رژیم غذایی......................................................................................................................................................................................................................................... 34

2-8-6-2-ورزش.................................................................................................................................................................................................................................................... 35

2-8-6-3-درمان با انسولین............................................................................................................................................................................................................................... 35

2-8-7-ارزیابی جنین........................................................................................................................................................................................................................................... 36

2-9-بیماری های تیروئید.................................................................................................................................................................................................................................... 38

2-9-1-عملکرد تیروئید مادر در حاملگی طبیعی....................................................................................................................................................................................... 38

2-9-2-هیپوتیروئیدی مادر................................................................................................................................................................................................................................ 38

2-9-3-هیپر تیروئیدی مادر............................................................................................................................................................................................................................... 39

2-9-4-ندول ها و سرطان تیروئید................................................................................................................................................................................................................... 43

2-10-عملکرد تیروئید جنین............................................................................................................................................................................................................................ 44

2-11-صرع.............................................................................................................................................................................................................................................................. 45

2-12-بررسی مقالات............................................................................................................................................................................................................................................ 47

فصل سوم:روش مطالعه......................................................................................................................................................................................................................................... 54

3-1-روش مطالعه.................................................................................................................................................................................................................................................. 55

3-2-روش نمونه گیری......................................................................................................................................................................................................................................... 55

3-3-روش تجزیه تحلیل اطلاعات.................................................................................................................................................................................................................... 55

فصل چهارم:یافته ها............................................................................................................................................................................................................................................... 57

فصل پنجم :بحث،نتیجه گیری و پیشنهادات................................................................................................................................................................................................ 66

5-1-بحث و نتیجه گیری.................................................................................................................................................................................................................................... 67

5-2-پیشنهادات..................................................................................................................................................................................................................................................... 68

فصل ششم:منابع.................................................................................................................................................................................................................................................... 69

فهرست منابع فارسی............................................................................................................................................................................................................................................. 70

فهرست منابع انگلیسی......................................................................................................................................................................................................................................... 71

ضمائم.........................................................................................................................................................................................................................................................................

چکیده انگلیسی...................................................................................................................................................................................................................................................... 73

فهرست جداول و نمودارها.....................................

جدول 2-1-معیارهای تشخیص پره اکلامپسی خفیف ............................................................................................................................................................................. 10

جدول2-2-معیارهای تشخیص پره اکلامپسی شدید................................................................................................................................................................................. 11

جدول2-3-عوامل خطرساز پره اکلامپسی.................................................................................................................................................................................................... 12

ی

جدول2-4-نظریه های سبب شناسی پره اکلامپسی.................................................................................................................................................................................. 13

جدول2-5-معیارهای وضع حمل در پره اکلامپسی .................................................................................................................................................................................. 19

جدول2-6-داروهای ضد پرفشاری خون در حاملگی.................................................................................................................................................................................. 23

جدول2-7-عوارض حاملگی در مبتلایان به دیابت...................................................................................................................................................................................... 29

جدول2-8-تدارک یک رژیم غذایی برای زنان حامله................................................................................................................................................................................. 34

جدول2-9-علل هیپر تیروئیدی........................................................................................................................................................................................................................ 39

جدول 2-10-درمان طوفان تیروئیدی............................................................................................................................................................................................................. 42

نمودار 4-1- نوع زایمان....................................................................................................................................................................................................................................... 61

نمودار 4-2- شیوع بیماری های مزمن در مادران باردار ........................................................................................................................................................................... 61

نمودار 4-3- نوع بیماری های مزمن در مادران باردار................................................................................................................................................................................. 62

نمودار 4-4- میزان استفاده از روش های کمک باروری ........................................................................................................................................................................... 62

نمودار4-5- میزان عوارض بارداری در گروه 1 ............................................................................................................................................................................................ 63

نمودار4-6- میزان عوارض بارداری در گروه 2 ............................................................................................................................................................................................ 63

نمودار 4-7- میانگین وزن نوزادان در دو گروه ............................................................................................................................................................................................ 64

نمودار 4-8- علل بستری نوزادان در NICU در گروه 2 .......................................................................................................................................................................... 65

نمودار4-9- علل بستری نوزادان در NICU در گروه 2 ............................................................................................................................................................................ 65